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Journal of Echocardiography Sep 2015
Topics: Echocardiography, Doppler; Heart Auscultation; Heart Murmurs; Humans
PubMed: 26184745
DOI: 10.1007/s12574-015-0248-2 -
JAMA Cardiology Jul 2022
Topics: Echocardiography; Heart Murmurs; Humans; Male
PubMed: 35829714
DOI: 10.1001/jamacardio.2022.0927 -
JAMA Cardiology Apr 2018Hutchinson-Gilford progeria syndrome (HGPS) is an ultrarare disorder associated with premature death due to cardiovascular events during the second decade of life.... (Observational Study)
Observational Study
IMPORTANCE
Hutchinson-Gilford progeria syndrome (HGPS) is an ultrarare disorder associated with premature death due to cardiovascular events during the second decade of life. However, because of its rarity (107 identified living patients), the natural history of cardiac disease remains uncharacterized. Therefore, meaningful cardiac end points for clinical trials have been difficult to establish.
OBJECTIVE
To examine the course of appearance of cardiac abnormalities in patients with HGPS to identify meaningful cardiac end points for use in future clinical trials.
DESIGN, SETTING, AND PARTICIPANTS
In this prospective, cross-sectional, observational study, 27 consecutive patients with clinically and genetically confirmed classic HGPS were evaluated at a single center for 1 visit from July 1, 2014, through February 29, 2016, before initiation of treatment.
EXPOSURE
Classic HGPS.
MAIN OUTCOMES AND MEASURES
Echocardiography was used to assess ventricular and valve function using standard techniques. Diastolic left ventricular (LV) function was assessed using tissue Doppler imaging. Previously published normative data were used to adjust findings to age and body size.
RESULTS
This study included 27 patients (median age, 5.6 years; age range, 2-17 years; 15 [56%] male). Among echocardiographic indicators, LV diastolic dysfunction, defined as a tissue Doppler septal or lateral early velocity z score less than -2, was the most prevalent abnormality, seen in 16 patients (59%). Diastolic dysfunction was seen in all age groups, and its prevalence increased with age, mirroring findings seen during normal aging. Indicators of LV diastolic function were more abnormal in older patients. The z scores for lateral and septal early velocities were lower (r = -0.77, P < .001; and r = -0.66, P < .001, respectively), whereas those for the ratio of early mitral inflow velocity to early diastolic tissue Doppler myocardial velocity were higher (r = 0.80, P < .001; and r = 0.72, P < .001, respectively) in older patients. Other echocardiographic findings, including LV hypertrophy, LV systolic dysfunction, and valve disease, were less prevalent in the first decade and were seen more frequently in the second decade.
CONCLUSIONS AND RELEVANCE
In this largest-to-date cohort of patients with HGPS, LV diastolic dysfunction was the most prevalent echocardiographic abnormality and its prevalence increased with aging. Echocardiographic indicators of LV diastolic function may be useful end points in future clinical trials in this patient population.
Topics: Adolescent; Blood Pressure; Child; Child, Preschool; Cross-Sectional Studies; Echocardiography; Electrocardiography; Female; Heart; Heart Murmurs; Humans; Male; Myocardium; Progeria; Prospective Studies; Pulse Wave Analysis
PubMed: 29466530
DOI: 10.1001/jamacardio.2017.5235 -
The Veterinary Record Apr 2022Spontaneous week-to-week variation in the presence and intensity of innocent cardiac murmurs in individual puppies is unknown.
BACKGROUND
Spontaneous week-to-week variation in the presence and intensity of innocent cardiac murmurs in individual puppies is unknown.
METHODS
Sixty privately owned, clinically healthy Cairn terrier and Dachshund puppies between 4 and 8 weeks of age were included. All dogs underwent weekly cardiac auscultation at the breeders' home by a veterinary cardiology specialist using an acoustic stethoscope. On each occasion, a phonocardiogram was recorded with an electronic stethoscope. Furthermore, all dogs were auscultated once at a first opinion veterinary practise and once at the authors' institution, where they also underwent an echocardiographic examination.
RESULTS
Two-hundred and eighty-one auscultations were conducted on 32 Cairn terriers and 28 Dachshunds, at the breeders' homes. Innocent murmurs were detected in 19 puppies. Two of these puppies had a detectable murmur on each auscultation. In five of the puppies, the murmur became undetectable during the observation period and in 12 puppies the murmur was intermittently audible. Auscultation at the authors' institution had an unpredictable effect on murmur presence and intensity. Phonocardiography revealed murmurs in 42 puppies. Interpretation of phonocardiograms by two independent observers showed nearly perfect agreement (κ = 0.859).
CONCLUSIONS
Remarkable and unpredictable spontaneous week-to-week variation was documented in the presence and intensity of innocent murmurs.
Topics: Animals; Dogs; Echocardiography; Heart Auscultation; Heart Murmurs; Stethoscopes
PubMed: 34807995
DOI: 10.1002/vetr.1173 -
Scientific Reports Mar 2022The hemodynamic consequences of aging have been extensively investigated during maximal incremental exercise. However, less is known about the effects of aging on...
The hemodynamic consequences of aging have been extensively investigated during maximal incremental exercise. However, less is known about the effects of aging on hemodynamics during submaximal steady-state exercise. The aim of the present investigation was to compare the hemodynamics of healthy elderly and young subjects during an exercise bout conducted at the gas threshold (GET) intensity. Two groups of healthy, physically active subjects were studied: the elderly group-EG (n = 11; > 60 years old) and the young group-YG (n = 13; < 35 years old). Both groups performed a 5-min rectangular exercise test at the GET intensity. Hemodynamics were measured using echocardiography. The main finding was that stroke volume responses were higher in the YG than the EG (72.5 ± 16.7 vs. 52.4 ± 8.4 ml, respectively). The increased stroke volume capacity in the YG was the consequence of a greater capacity to increase cardiac preload and contractility and, to a lesser extent, to reduce systemic vascular resistance. Importantly, the atrial contribution to ventricular diastolic filling was substantially higher in the YG when compared to the EG.
Topics: Adult; Aged; Cardiac Output; Diastole; Exercise; Hemodynamics; Humans; Middle Aged; Stroke Volume; Systolic Murmurs
PubMed: 35264702
DOI: 10.1038/s41598-022-07933-7 -
Veterinary Sciences Oct 2022Cardiac auscultation is one of the most important clinical tools to identify patients with a potential heart disease. Although several publications have reported the...
BACKGROUND
Cardiac auscultation is one of the most important clinical tools to identify patients with a potential heart disease. Although several publications have reported the prevalence of murmurs in cats, little information is available in relation to the exact origin of the blood flow turbulences responsible for these murmurs. The aim of this study was to determine the prevalence and clinical significance of murmurs detected during physical examination in cats.
METHODS
Retrospective evaluation of clinical records and echocardiographic examinations performed in cats for investigation of heart murmurs; Results: Records of 856 cats with full clinical information were available for review. The cause of murmur was identified in 93.1% of cases (72.3% with single blood flow turbulence, 26.4% with two, and 1.3% with three identifiable sources of murmur). Systolic anterior motion of the mitral valve (SAM) was the primary cause of murmur in this population (39.2%), followed by dynamic right ventricular outflow tract obstruction (DRVOTO) (32%) and flow murmurs (6.9%). Most cats with a murmur (56.7%) did not present any structural cardiac abnormality.
CONCLUSIONS
This study indicates that some heart murmur characteristics (timing, loudness and point of maximal intensity) can potentially predict the presence of an underlying cardiac disease.
PubMed: 36288177
DOI: 10.3390/vetsci9100564 -
Journal of Veterinary Cardiology : the... Dec 2015A dog or a cat has an incidentally detected heart murmur if the murmuris an unexpected discovery during a veterinary consultation that was not initially focused on the... (Review)
Review
A dog or a cat has an incidentally detected heart murmur if the murmuris an unexpected discovery during a veterinary consultation that was not initially focused on the cardiovascular system. This document presents approaches for managing dogs and cats that have incidentally-detected heart murmurs, with an emphasis on murmur characteristics, signalment profiling, and multifactorial decision-making to choose an optimal course for a given patient.
Topics: Animals; Cat Diseases; Cats; Decision Trees; Diagnostic Techniques, Cardiovascular; Dog Diseases; Dogs; Heart Murmurs; Incidental Findings
PubMed: 26777392
DOI: 10.1016/j.jvc.2015.05.001 -
European Heart Journal Sep 2014
Topics: Adolescent; Echocardiography; Female; Heart Murmurs; Heart Neoplasms; Heart Ventricles; Humans; Myxoma; Papillary Muscles; Ventricular Outflow Obstruction
PubMed: 24906618
DOI: 10.1093/eurheartj/ehu229 -
British Journal of Sports Medicine Jan 2022We assessed whether the presence and character of a cardiac murmur in adolescents were associated with structural heart disease that confers risk of sudden cardiac death...
Do 'pathologic' cardiac murmurs in adolescents identify structural heart disease? An evaluation of 15 141 active adolescents for conditions that put them at risk of sudden cardiac death.
OBJECTIVES
We assessed whether the presence and character of a cardiac murmur in adolescents were associated with structural heart disease that confers risk of sudden cardiac death (SCD).
METHODS
We performed a retrospective analysis of 15 141 adolescents age 12-19 who underwent a heart screen with history, physical examination and ECG. Participants with any screening abnormality underwent an echocardiogram for the assessment of structural heart disease. Murmurs were classified as physiological or pathological according to standard clinical criteria, and participants with murmurs were compared with a comparison group without murmurs. The primary outcome was echocardiogram-detected structural heart disease associated with SCD.
RESULTS
905 participants with a cardiac murmur (mean age 15.8; 58% male) and 4333 participants without a murmur (comparison group; mean age 15.8; 55% male) had an echocardiogram to detect structural heart disease. 743 (82%) murmurs were described as physiological and 162 (18%) as pathological. Twenty-five (2.8%) participants with murmurs and 61 (1.4%) participants without murmurs had structural heart disease. Three (0.3%) participants in the murmur group were diagnosed with hypertrophic cardiomyopathy (HCM) which was the only identified condition associated with SCD. Two participants with HCM had physiological murmurs, one had a pathological murmur, and all three had an abnormal ECG. The most common minor structural heart disease was bicuspid aortic valve in both the murmur (7; 0.8%) and comparison (20; 0.5%) groups. The positive predictive value of physiological versus pathological murmurs for identifying any structural heart disease was 2.4% versus 4.3% (p=0.21), respectively. The positive predictive value of having any murmur versus no murmur for identifying structural heart disease was 2.8% versus 1.4% (p=0.003), respectively.
CONCLUSIONS
In adolescents, the traditional classification of cardiac murmurs as 'physiologic' or 'pathologic' does not differentiate for structural heart disease that puts individuals at risk for SCD. We recommend ECG evaluation in all patients with a cardiac murmur found during preparticipation screening to increase detection of HCM.
Topics: Adolescent; Adult; Child; Death, Sudden, Cardiac; Echocardiography; Female; Heart Diseases; Heart Murmurs; Humans; Male; Retrospective Studies; Young Adult
PubMed: 33451997
DOI: 10.1136/bjsports-2019-101718 -
Disease-a-month : DM Aug 2018
Review
Topics: Adult; Aged; Aged, 80 and over; Aortic Valve Stenosis; Aspirin; Calcium; Cardiac Tamponade; Clavicle; Coronary Vessels; Dizziness; Female; Heart Murmurs; Hepcidins; Humans; Hyperlipidemias; Internal Medicine; Iron; Male; Middle Aged; Nail Diseases; Varicose Ulcer; Young Adult
PubMed: 29880261
DOI: 10.1016/j.disamonth.2018.05.004